From leadership research to district action: A dynamic journey of comprehensive school health policy implementation in response to the COVID-19 pandemic in Lombok, Indonesia

AI-assisted editorial implementation guide. Proposed district actions are separate from the original authors’ findings and recommendations. Independent peer review of this guide is not asserted.

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Evidence and transfer

Education-related source: verify which participants, institutions and outcomes were actually studied before district adoption. Source publication type: research-article. License and identity checks do not establish study quality or causality.

Original authors’ abstract, reproduced under the source license:

Background Coronavirus disease 2019 (COVID-19) pandemic in March 2020 led to new restrictive policies in several countries, including Indonesia. The comprehensive school health (CSH) framework provides overall guidance for interventions most effective in achieving specific outcomes related to health, nutrition, and education, and creating CSH programmes that account for the main contextual variations in Indonesian communities and schools is important. This study aimed to clarify how school health-related policies made before and after the COVID-19 pandemic responded to COVID-19 control measures on Lombok Island, Indonesia. Method This was a qualitative observational analytic study. Researchers reviewed and analysed school health policy, held separate confirmation discussions and interviews with stakeholders and key informants, and observed policy implementation at public and private schools in Mataram. Results The analysis found weaknesses and opportunities. Weakness included lack of guidelines, comprehensive planning, inconsistent hierarchy of roles and responsibilities, and social and cultural barriers. Opportunities included the importance of funding for consistent CSH implementation, monitoring and evaluation system, implementation between public and private schools, and decentralisation. Positive findings included CSH policy integration into teaching and learning activities, regular healthy school competition program, teachers as role models, existing coordination and distribution of responsibilities between relevant stakeholders, and authorising schools to make needed adjustments. Factors influencing school health efforts included curriculum, school organisation, personal ethos, and healthcare provider partnerships. To effectively promote school health efforts, schools must assess existing health problems within the school environment and surroundings, organisational structure and capabilities including knowledge and skills, commitment, and leadership aspects. Conclusion The COVID-19 pandemic has prompted the implementation of CSH policies in schools of Lombok Island, demonstrating flexibility and dedication to student welfare. Despite confusion due to changing regulations, collaboration with local health organisations and community support has resulted in effective policy implementation.

Study methods

The multiple case study design of this study used document reviews and key informant interviews to determine the factors influencing the implementation of school health. A case study examines a current phenomenon in its present context and may include one or more cases to compare a different or similar circumstance. This study focused on the three phases of school health policy and its implementation: Phases #1 and #2, before and during the COVID-19 pandemic, respectively, and Phase #3, after the COVID-19 pandemic. These phases were categorised based on the epidemic timeframe of the SARS-CoV variant. In the conceptual framework, Phase 1 corresponds to the establishment of CSH in Indonesia before the pandemic of the COVID-19, Phase 2 to the early-phase response that included the Alpha and Delta varieties, and Phase 3 to the chronic phase reaction and recovery phase, which included the Omicron version. The document reviews and key informant interviews were used to triangulate the potential convergence of the data acquired from various data sources and ascertain the consistency of the findings across each phase.

Limitations

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A 90-day district inquiry

Days 1–15 · Appraise. Read the source methods, recruitment, comparator, outcomes and limitations. Record how the study setting differs from your district and which claim the design can support.
Days 16–30 · Design. Select one recurring district decision. Publish the decision owner, evidence requirements, consultation process and appeal route; test the process on a bounded low-risk decision. Agree participation, privacy protections, baseline and stopping rules before starting.
Days 31–60 · Observe. Collect the pre-agreed measures, keep a log of implementation changes and invite confidential voluntary feedback. Preserve existing support for staff and learners.
Days 61–90 · Decide. Track decision time, unresolved objections, documented reasons, appeals and access differences. Review whether the process changes who can participate and who carries the burden. Make a dated decision to stop, revise or extend the inquiry.

Board decision brief

Present the local problem, source setting, evidence limits, intervention, responsible owner, total cost, measured changes and uncertainty. Separate staff perceptions, implementation measures and student learning outcomes.

Attribution and reuse

Cut Warnaini; Abiyyu Didar Haq; Hamsu Kadriyan; Fumiko Shibuya; Jun Kobayashi. A dynamic journey of comprehensive school health policy implementation in response to the COVID-19 pandemic in Lombok, Indonesia. Tropical Medicine and Health (2025-02-20). https://doi.org/10.1186/s41182-025-00690-z

Prepared 2026-11-07. Source authorship and DOI are preserved. The abstract and source passages are attributed extracts; this editorial guide is offered under the same CC BY 4.0 license.